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Remote Prior Authorization Jobs in Virginia (NOW HIRING)

Sentara Healthcare

Authorization Coordinator II

Norfolk, VA · On-site +1

$18 - $22.25/hr

Request and secure prior authorizations for procedures, diagnostic testing, hospital admissions ... Position is available as Remote (SWS State Eligible) Alabama, Delaware, Florida, Georgia, Idaho ...

Sentara Healthcare

Authorization Coordinator II

Norfolk, VA · On-site +1

$18 - $22.25/hr

Request and secure prior authorizations for procedures, diagnostic testing, hospital admissions ... Position is available as Remote (SWS State Eligible) Alabama, Delaware, Florida, Georgia, Idaho ...

ICF

Salesforce PSS Developer DHS (Remote)

Reston, VA · Remote

$57.75 - $76.50/hr

Remote work is authorized. Must supportUS Eastern time zoneworking hours. What You Will Do ... Prior experienceperformingDevOpsactivitiesincluding package creation & deployment,code scan ...

ICF

Senior Software Engineer (Python) - Remote

Reston, VA · Remote

$127K - $168K/yr

You will be closely involved in the authorization of FHIR resources that enable these capabilities ... Prior experience working remotely in a full-time capacity. Job Location: Remote (USA). Travel for a ...

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All JobsPrior Authorization JobsRemote Prior Authorization JobsRemote Prior Authorization Jobs in Virginia

Remote Prior Authorization information

See Virginia salary details

$13

$20

$31

How much do remote prior authorization jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for remote prior authorization in Virginia is $20.71, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $22.88 per hour, depending on experience, location, and employer.

What are remote prior authorization jobs?

Remote prior authorization jobs involve reviewing and processing requests from healthcare providers to determine if specific medical treatments, medications, or procedures are covered by a patient's insurance plan. Employees in these roles work from home, utilizing online systems to evaluate clinical information, communicate with providers, and ensure compliance with insurance policies. This position requires a strong understanding of medical terminology, insurance guidelines, and attention to detail to facilitate timely and accurate approvals or denials. Remote prior authorization specialists help streamline patient care by acting as a liaison between healthcare providers and insurance companies.

What are some common challenges faced by Remote Prior Authorization specialists, and how can they be addressed?

Remote Prior Authorization specialists often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and maintaining clear communication with healthcare providers and payers. Staying organized and up-to-date on payer policies is crucial, as requirements can vary widely between insurers. Utilizing workflow management tools and fostering strong collaboration with clinical and administrative teams can help streamline processes and reduce delays, ultimately ensuring patients receive timely care.

What are the key skills and qualifications needed to thrive as a Remote Prior Authorization Specialist, and why are they important?

To thrive as a Remote Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, insurance portals, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are crucial soft skills in this role. These skills ensure timely and accurate processing of authorizations, reducing claim denials and supporting efficient patient care.

What is the difference between Remote Prior Authorization vs Remote Medical Coder?

AspectRemote Prior AuthorizationRemote Medical Coder
Required CredentialsMedical credentials, insurance knowledgeMedical coding certification (CPC, CCS)
Work EnvironmentHealthcare offices, insurance companies, remoteHealthcare facilities, remote coding jobs
Industry UsageInsurance, healthcare providersHospitals, clinics, billing companies
Job FocusReviewing and approving insurance requestsTranslating medical records into codes

Remote Prior Authorization and Remote Medical Coder roles both operate within the healthcare industry but focus on different tasks. Remote Prior Authorization involves reviewing insurance requests for coverage approval, requiring insurance and medical knowledge. Remote Medical Coders translate medical records into standardized codes, primarily focusing on billing and documentation. Both roles can be performed remotely and require healthcare-related credentials, but their daily responsibilities and skill sets differ significantly.

What Are Remote Prior Authorization Jobs?

Remote prior authorization jobs focus on working with insurance companies to coordinate benefit coverage and get approval to provide care for a patient. In this pre-authorization role, you may collect documentation and proof of insurance, perform data entry, help evaluate the need for a particular process, and otherwise work from home to help manage the prior authorization process. Remote prior authorization personnel often answer telephone calls to provide consultations, perform initial benefit verification, document case status, actions, and outcomes in a database, and use customer service skills to help expedite cases as needed. Since this is a remote call center-style job, you may be asked to arrange for a quiet office in your house that is free of distractions.

More about Remote Prior Authorization jobs
What are the most commonly searched types of Prior Authorization jobs in Virginia? The most popular types of Prior Authorization jobs in Virginia are:
What are popular job titles related to Remote Prior Authorization jobs in Virginia? For Remote Prior Authorization jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization jobs in Virginia look for? The top searched job categories for Remote Prior Authorization jobs in Virginia are:
What cities in Virginia are hiring for Remote Prior Authorization jobs? Cities in Virginia with the most Remote Prior Authorization job openings:
Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Virginia as of July 2026, with employment types broken down into 77% Full Time, 17% Part Time, and 6% Temporary. Highlights an 100% Remote job distribution, with an average salary of $43,087 per year, or $20.7 per hour.
Pharmacy Prior Authorization Coordinator I

Pharmacy Prior Authorization Coordinator I

Sentara Healthcare

Virginia Beach, VA • On-site, Remote

$17.75 - $23.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Sentara Health rating

6.9

Company rating: 6.9 out of 10

Based on 392 frontline employees who took The Breakroom Quiz

449th of 886 rated healthcare providers

Job description

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is looking to hire Pharmacy Prior Authorization Coordinator 1:
This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming
Shift: Monday- Friday from 8:00am to 8:00pm and must be flexible to work on weekends.
The Pharmacy Prior Authorization Coordinator I is responsible for delivering high-quality customer service by answering and managing calls from members, provider offices, and pharmacies. This role supports the processing of prior authorization (PA) requests for pharmacy benefit medications, ensuring accuracy, compliance with regulatory and clinical guidelines, and alignment with client performance standards. The Coordinator I works under general supervision, using established protocols and systems to support timely, efficient, and accurate PA determinations.
This role uses various business systems and tools to retrieve information, analyze requests, and enter prior authorization data required for claims adjudication. The Coordinator I applies reasoning skills to identify incomplete information and determine appropriate actions based on client-specific criteria and clinical protocols (e.g., approve, pend, refer for clinical decision). The position interacts regularly with internal teams and external stakeholders to ensure consistent, high-quality service delivery. Work is performed under general supervision, with reliance on documented procedures, training, and prior experience to guide day-to-day activities.
Key Responsibilities
  • Verify member insurance eligibility and pharmacy benefit coverage.

  • Communicate with members and providers regarding basic pharmacy inquiries and PA status.

  • Accurately enter and process prior authorization (PA) requests into the system, prioritizing appropriately.

  • Ensure PA requests are processed and finalized within required turnaround times (TAT) and client Performance Guarantees (PGs), using provided clinical guidelines.

  • Review medication history and assess for formulary alternatives and "tried and failed" drugs.

  • Document all relevant PA information clearly and accurately, including approval or denial rationale.

  • Send PA status updates to providers and pharmacies via fax or other required methods.

  • Adhere to defined roles and responsibilities related to clinical decision-making boundaries.

  • Meet or exceed productivity and accuracy targets for PA processing.

  • Coordinate with members, providers, and pharmacies to obtain missing information or clarification.

  • Make outbound calls to gather additional information or respond to inquiries related to PAs, clinical programs, or claim adjudication.

  • Collaborate with Pharmacy Concierge teams to resolve questions or issues related to PA processing or pharmacy benefits.

  • Maintain strict confidentiality and security of all member and PA-related data, following applicable protocols for data handling and storage.

  • In addition to the above responsibilities, other duties may be assigned.

Education
  • High School Diploma or GED strongly preferred.

Experience
  • 1 year healthcare experience required.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: 19.04/HR - 31.73/HR. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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